NPI | 1063840072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.01.010712) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.010712) |
Enumeration Date | 2013-10-30 |
Last Update Date | 2022-08-08 |